Chronic Pancreatitis

Question 1

Chronic pancreatitis

Answer 1

Irreversible pancreatic damage

Question 2

Stellate cells

Answer 2

Have role in inflammation of both acute and chronic pancreatitis

Question 3

Strong association between chronic pancreatitis and

Answer 3

Smoking lead to
Autodigestion

Question 4

………….is the most common cause of clinically apparent chronic pancreatitis, whereas……………..is the most frequent cause in children

Answer 4

Alcoholism

cystic fibrosis (Mutations of CFTR)

Question 5

Type 1 AIP is often associated with involvement of other organs in the setting of IgG4-related disease

Answer 5

Bilateral submandibular gland enlargement
Characteristic renal lesions
Retroperitoneal fibrosis
Stricturing of the suprapancreatic biliary tree( IgG4-associated cholangitis)

Question 6

isolated intrahepatic bile duct strictures (type 1AIP Only)

Detected with

Answer 6

which can mimic primary sclerosing cholangitis
, and is referred to as IgG4-related sclerosing cholangitis
previously termed IgG4-associated cholangitis).

ERCP + MRCP

Question 7

CT scan demonstration

Answer 7

diffuse or focal enlargement during active disease, unless the gland is atrophic due to previous disease

Question 8

Patients with chronic pancreatitis respond very well to glucocorticoids

A poor response should raise suspicion of an alternate diagnosis, such as……………

Answer 8

pancreatic cancer

Question 9

may be needed to confirm the diagnosis of exocrine pancreatic insufficiency.

Answer 9

fecal elastase-1 level

Question 10

Modalities of diagnosis

Answer 10

Abdominal CT imaging is the initial modality of choice,
followed by MRI, endoscopic ultrasound, and pancreas function testing.

Question 11

the diagnostic test with the best sensitivity.

Answer 11

is the hormone stimulation test using secretin

The secretin test becomes abnormal when≥60%of the pancreatic exocrine function has been lost.
This usually correlates well with the onset of chronic abdominal pain.

Question 12

Although most patients develop hyperglycemia due to insulin deficiency but……………… are uncommon.
Likewise, end-organ damage ………………..is also uncommon.

Answer 12

diabetic ketoacidosis and diabetic coma

retinopathy, neuropathy, nephropathy

Nondiabetic retinopathy may be due to vitamin A and/or zinc deficiency.

Question 13

Patients with………………… have an increased risk for pancreatic cancer compared to other forms of chronic pancreatitis

Answer 13

hereditary PRSS1 or tropical pancreatitis